|
HC PENTOBARBITOL NEMBUTAL LVL
|
Facility
|
IP
|
$182.07
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100572
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.72 |
| Max. Negotiated Rate |
$163.86 |
| Rate for Payer: Aetna Commercial |
$154.76
|
| Rate for Payer: BCBS Trust/PPO |
$150.37
|
| Rate for Payer: BCN Commercial |
$150.37
|
| Rate for Payer: Cash Price |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$156.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.66
|
| Rate for Payer: Healthscope Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.76
|
| Rate for Payer: Nomi Health Commercial |
$149.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.55
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.22
|
| Rate for Payer: UHC Core |
$152.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.55
|
|
|
HC PENTOBARBITOL NEMBUTAL LVL
|
Facility
|
OP
|
$182.07
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100572
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.10 |
| Max. Negotiated Rate |
$163.86 |
| Rate for Payer: Aetna Commercial |
$154.76
|
| Rate for Payer: Aetna Medicare |
$47.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.90
|
| Rate for Payer: BCBS Complete |
$33.70
|
| Rate for Payer: BCBS MAPPO |
$45.52
|
| Rate for Payer: BCBS Trust/PPO |
$149.68
|
| Rate for Payer: BCN Commercial |
$149.68
|
| Rate for Payer: BCN Medicare Advantage |
$45.52
|
| Rate for Payer: Cash Price |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$156.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.52
|
| Rate for Payer: Healthscope Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.55
|
| Rate for Payer: Mclaren Medicaid |
$32.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.79
|
| Rate for Payer: Meridian Medicaid |
$33.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.76
|
| Rate for Payer: Nomi Health Commercial |
$149.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.55
|
| Rate for Payer: PACE Senior Care Partners |
$43.24
|
| Rate for Payer: PACE SWMI |
$45.52
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: PHP Medicare Advantage |
$45.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.40
|
| Rate for Payer: Priority Health Medicare |
$45.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.72
|
| Rate for Payer: Railroad Medicare Medicare |
$45.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.22
|
| Rate for Payer: UHC Core |
$152.03
|
| Rate for Payer: UHC Exchange |
$45.52
|
| Rate for Payer: UHC Medicaid |
$32.10
|
| Rate for Payer: UHC Medicare Advantage |
$45.52
|
| Rate for Payer: UHCCP Medicaid |
$32.10
|
| Rate for Payer: VA VA |
$45.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.55
|
|
|
HC PEP VALVE SUPPLY
|
Facility
|
IP
|
$55.67
|
|
| Hospital Charge Code |
27000134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.75 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Nomi Health Commercial |
$45.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.99
|
| Rate for Payer: UHC Core |
$46.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC PEP VALVE SUPPLY
|
Facility
|
OP
|
$55.67
|
|
| Hospital Charge Code |
27000134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: Aetna Medicare |
$14.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.40
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$13.92
|
| Rate for Payer: BCBS Trust/PPO |
$45.77
|
| Rate for Payer: BCN Commercial |
$45.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.92
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.61
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Nomi Health Commercial |
$45.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PACE Senior Care Partners |
$13.22
|
| Rate for Payer: PACE SWMI |
$13.92
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: PHP Medicare Advantage |
$13.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.43
|
| Rate for Payer: Priority Health Medicare |
$14.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.75
|
| Rate for Payer: Railroad Medicare Medicare |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.99
|
| Rate for Payer: UHC Core |
$46.48
|
| Rate for Payer: UHC Exchange |
$13.92
|
| Rate for Payer: UHC Medicaid |
$9.81
|
| Rate for Payer: UHC Medicare Advantage |
$13.92
|
| Rate for Payer: UHCCP Medicaid |
$9.81
|
| Rate for Payer: VA VA |
$13.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
OP
|
$5,268.14
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$928.77 |
| Max. Negotiated Rate |
$4,741.33 |
| Rate for Payer: Aetna Commercial |
$4,477.92
|
| Rate for Payer: Aetna Medicare |
$1,369.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,646.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,646.29
|
| Rate for Payer: BCBS Complete |
$975.13
|
| Rate for Payer: BCBS MAPPO |
$1,317.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,330.94
|
| Rate for Payer: BCN Commercial |
$4,330.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.04
|
| Rate for Payer: Cash Price |
$4,214.51
|
| Rate for Payer: Cofinity Commercial |
$4,530.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,214.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.04
|
| Rate for Payer: Healthscope Commercial |
$4,741.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,951.11
|
| Rate for Payer: Mclaren Medicaid |
$928.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,382.89
|
| Rate for Payer: Meridian Medicaid |
$975.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,514.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,448.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,477.92
|
| Rate for Payer: Nomi Health Commercial |
$4,319.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,951.11
|
| Rate for Payer: PACE Senior Care Partners |
$1,251.18
|
| Rate for Payer: PACE SWMI |
$1,317.04
|
| Rate for Payer: PHP Commercial |
$4,477.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$928.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,583.28
|
| Rate for Payer: Priority Health Medicare |
$1,330.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,666.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,317.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,635.96
|
| Rate for Payer: UHC Core |
$4,398.90
|
| Rate for Payer: UHC Exchange |
$1,317.04
|
| Rate for Payer: UHC Medicaid |
$928.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,317.04
|
| Rate for Payer: UHCCP Medicaid |
$928.77
|
| Rate for Payer: VA VA |
$1,317.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,951.11
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
IP
|
$5,268.14
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,666.63 |
| Max. Negotiated Rate |
$4,741.33 |
| Rate for Payer: Aetna Commercial |
$4,477.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,350.96
|
| Rate for Payer: BCN Commercial |
$4,350.96
|
| Rate for Payer: Cash Price |
$4,214.51
|
| Rate for Payer: Cofinity Commercial |
$4,530.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,214.51
|
| Rate for Payer: Healthscope Commercial |
$4,741.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,951.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,477.92
|
| Rate for Payer: Nomi Health Commercial |
$4,319.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,951.11
|
| Rate for Payer: PHP Commercial |
$4,477.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,583.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,666.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,635.96
|
| Rate for Payer: UHC Core |
$4,398.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,951.11
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
IP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.36
|
| Rate for Payer: BCN Commercial |
$61.36
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$60.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.38
|
| Rate for Payer: UHC Core |
$62.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
OP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.22
|
| Rate for Payer: BCBS Complete |
$13.75
|
| Rate for Payer: BCBS MAPPO |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$61.07
|
| Rate for Payer: BCN Commercial |
$61.07
|
| Rate for Payer: BCN Medicare Advantage |
$18.57
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.57
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Mclaren Medicaid |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.50
|
| Rate for Payer: Meridian Medicaid |
$13.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$60.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PACE Senior Care Partners |
$17.64
|
| Rate for Payer: PACE SWMI |
$18.57
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: PHP Medicare Advantage |
$18.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.63
|
| Rate for Payer: Priority Health Medicare |
$18.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.38
|
| Rate for Payer: UHC Core |
$62.03
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$18.57
|
| Rate for Payer: UHCCP Medicaid |
$13.10
|
| Rate for Payer: VA VA |
$18.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
IP
|
$14,383.08
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,010.62 |
| Max. Negotiated Rate |
$12,944.77 |
| Rate for Payer: Aetna Commercial |
$12,225.62
|
| Rate for Payer: BCBS Trust/PPO |
$11,878.99
|
| Rate for Payer: BCN Commercial |
$11,878.99
|
| Rate for Payer: Cash Price |
$11,506.46
|
| Rate for Payer: Cofinity Commercial |
$12,369.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,506.46
|
| Rate for Payer: Healthscope Commercial |
$12,944.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,787.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,225.62
|
| Rate for Payer: Nomi Health Commercial |
$11,794.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,787.31
|
| Rate for Payer: PHP Commercial |
$12,225.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,513.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,010.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,657.11
|
| Rate for Payer: UHC Core |
$12,009.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,787.31
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
OP
|
$14,383.08
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,535.74 |
| Max. Negotiated Rate |
$12,944.77 |
| Rate for Payer: Aetna Commercial |
$12,225.62
|
| Rate for Payer: Aetna Medicare |
$3,739.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,494.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,494.71
|
| Rate for Payer: BCBS Complete |
$2,662.31
|
| Rate for Payer: BCBS MAPPO |
$3,595.77
|
| Rate for Payer: BCBS Trust/PPO |
$11,824.33
|
| Rate for Payer: BCN Commercial |
$11,824.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,595.77
|
| Rate for Payer: Cash Price |
$11,506.46
|
| Rate for Payer: Cofinity Commercial |
$12,369.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,506.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,595.77
|
| Rate for Payer: Healthscope Commercial |
$12,944.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,787.31
|
| Rate for Payer: Mclaren Medicaid |
$2,535.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,775.56
|
| Rate for Payer: Meridian Medicaid |
$2,662.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,135.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,955.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,225.62
|
| Rate for Payer: Nomi Health Commercial |
$11,794.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,787.31
|
| Rate for Payer: PACE Senior Care Partners |
$3,415.98
|
| Rate for Payer: PACE SWMI |
$3,595.77
|
| Rate for Payer: PHP Commercial |
$12,225.62
|
| Rate for Payer: PHP Medicare Advantage |
$3,595.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,535.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,513.28
|
| Rate for Payer: Priority Health Medicare |
$3,631.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,010.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,595.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,657.11
|
| Rate for Payer: UHC Core |
$12,009.87
|
| Rate for Payer: UHC Exchange |
$3,595.77
|
| Rate for Payer: UHC Medicaid |
$2,535.74
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.77
|
| Rate for Payer: UHCCP Medicaid |
$2,535.74
|
| Rate for Payer: VA VA |
$3,595.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,787.31
|
|
|
HC PERCLOSE
|
Facility
|
IP
|
$1,073.27
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$747.00 |
| Max. Negotiated Rate |
$965.94 |
| Rate for Payer: Aetna Commercial |
$912.28
|
| Rate for Payer: BCBS Trust/PPO |
$886.41
|
| Rate for Payer: BCN Commercial |
$886.41
|
| Rate for Payer: Cash Price |
$858.62
|
| Rate for Payer: Cofinity Commercial |
$923.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.62
|
| Rate for Payer: Healthscope Commercial |
$965.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.28
|
| Rate for Payer: Nomi Health Commercial |
$880.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.95
|
| Rate for Payer: PHP Commercial |
$912.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$747.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.48
|
| Rate for Payer: UHC Core |
$896.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.95
|
|
|
HC PERCLOSE
|
Facility
|
OP
|
$1,073.27
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.22 |
| Max. Negotiated Rate |
$965.94 |
| Rate for Payer: Aetna Commercial |
$912.28
|
| Rate for Payer: Aetna Medicare |
$279.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.40
|
| Rate for Payer: BCBS Complete |
$198.66
|
| Rate for Payer: BCBS MAPPO |
$268.32
|
| Rate for Payer: BCBS Trust/PPO |
$882.34
|
| Rate for Payer: BCN Commercial |
$882.34
|
| Rate for Payer: BCN Medicare Advantage |
$268.32
|
| Rate for Payer: Cash Price |
$858.62
|
| Rate for Payer: Cofinity Commercial |
$923.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.32
|
| Rate for Payer: Healthscope Commercial |
$965.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.95
|
| Rate for Payer: Mclaren Medicaid |
$189.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.73
|
| Rate for Payer: Meridian Medicaid |
$198.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.28
|
| Rate for Payer: Nomi Health Commercial |
$880.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.95
|
| Rate for Payer: PACE Senior Care Partners |
$254.90
|
| Rate for Payer: PACE SWMI |
$268.32
|
| Rate for Payer: PHP Commercial |
$912.28
|
| Rate for Payer: PHP Medicare Advantage |
$268.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.74
|
| Rate for Payer: Priority Health Medicare |
$271.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$747.00
|
| Rate for Payer: Railroad Medicare Medicare |
$268.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.48
|
| Rate for Payer: UHC Core |
$896.18
|
| Rate for Payer: UHC Exchange |
$268.32
|
| Rate for Payer: UHC Medicaid |
$189.22
|
| Rate for Payer: UHC Medicare Advantage |
$268.32
|
| Rate for Payer: UHCCP Medicaid |
$189.22
|
| Rate for Payer: VA VA |
$268.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.95
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$6,639.53
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,170.55 |
| Max. Negotiated Rate |
$5,975.58 |
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna Medicare |
$1,726.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,074.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,074.85
|
| Rate for Payer: BCBS Complete |
$1,228.98
|
| Rate for Payer: BCBS MAPPO |
$1,659.88
|
| Rate for Payer: BCBS Trust/PPO |
$5,458.36
|
| Rate for Payer: BCN Commercial |
$5,458.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,659.88
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,659.88
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.65
|
| Rate for Payer: Mclaren Medicaid |
$1,170.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,742.88
|
| Rate for Payer: Meridian Medicaid |
$1,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,908.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,825.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Nomi Health Commercial |
$5,444.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PACE Senior Care Partners |
$1,576.89
|
| Rate for Payer: PACE SWMI |
$1,659.88
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,659.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,170.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,776.39
|
| Rate for Payer: Priority Health Medicare |
$1,676.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,621.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,659.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,842.79
|
| Rate for Payer: UHC Core |
$5,544.01
|
| Rate for Payer: UHC Exchange |
$1,659.88
|
| Rate for Payer: UHC Medicaid |
$1,170.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,659.88
|
| Rate for Payer: UHCCP Medicaid |
$1,170.55
|
| Rate for Payer: VA VA |
$1,659.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.65
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$6,639.53
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,621.11 |
| Max. Negotiated Rate |
$5,975.58 |
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: BCBS Trust/PPO |
$5,483.59
|
| Rate for Payer: BCN Commercial |
$5,483.59
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Nomi Health Commercial |
$5,444.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,776.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,621.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,842.79
|
| Rate for Payer: UHC Core |
$5,544.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.65
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$18,046.39
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,181.58 |
| Max. Negotiated Rate |
$16,241.75 |
| Rate for Payer: Aetna Commercial |
$15,339.43
|
| Rate for Payer: Aetna Medicare |
$4,692.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,639.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,639.50
|
| Rate for Payer: BCBS Complete |
$3,340.39
|
| Rate for Payer: BCBS MAPPO |
$4,511.60
|
| Rate for Payer: BCBS Trust/PPO |
$14,835.94
|
| Rate for Payer: BCN Commercial |
$14,835.94
|
| Rate for Payer: BCN Medicare Advantage |
$4,511.60
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cofinity Commercial |
$15,519.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,437.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,511.60
|
| Rate for Payer: Healthscope Commercial |
$16,241.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,534.79
|
| Rate for Payer: Mclaren Medicaid |
$3,181.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,737.18
|
| Rate for Payer: Meridian Medicaid |
$3,340.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,188.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,962.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,339.43
|
| Rate for Payer: Nomi Health Commercial |
$14,798.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,534.79
|
| Rate for Payer: PACE Senior Care Partners |
$4,286.02
|
| Rate for Payer: PACE SWMI |
$4,511.60
|
| Rate for Payer: PHP Commercial |
$15,339.43
|
| Rate for Payer: PHP Medicare Advantage |
$4,511.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,181.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,700.36
|
| Rate for Payer: Priority Health Medicare |
$4,556.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,560.29
|
| Rate for Payer: Railroad Medicare Medicare |
$4,511.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,880.82
|
| Rate for Payer: UHC Core |
$15,068.74
|
| Rate for Payer: UHC Exchange |
$4,511.60
|
| Rate for Payer: UHC Medicaid |
$3,181.58
|
| Rate for Payer: UHC Medicare Advantage |
$4,511.60
|
| Rate for Payer: UHCCP Medicaid |
$3,181.58
|
| Rate for Payer: VA VA |
$4,511.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,534.79
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$18,046.39
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,560.29 |
| Max. Negotiated Rate |
$16,241.75 |
| Rate for Payer: Aetna Commercial |
$15,339.43
|
| Rate for Payer: BCBS Trust/PPO |
$14,904.51
|
| Rate for Payer: BCN Commercial |
$14,904.51
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cofinity Commercial |
$15,519.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,437.11
|
| Rate for Payer: Healthscope Commercial |
$16,241.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,534.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,339.43
|
| Rate for Payer: Nomi Health Commercial |
$14,798.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,534.79
|
| Rate for Payer: PHP Commercial |
$15,339.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,700.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,560.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,880.82
|
| Rate for Payer: UHC Core |
$15,068.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,534.79
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$28,657.20
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,052.26 |
| Max. Negotiated Rate |
$25,791.48 |
| Rate for Payer: Aetna Commercial |
$24,358.62
|
| Rate for Payer: Aetna Medicare |
$7,450.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,955.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,955.38
|
| Rate for Payer: BCBS Complete |
$5,304.45
|
| Rate for Payer: BCBS MAPPO |
$7,164.30
|
| Rate for Payer: BCBS Trust/PPO |
$23,559.08
|
| Rate for Payer: BCN Commercial |
$23,559.08
|
| Rate for Payer: BCN Medicare Advantage |
$7,164.30
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cofinity Commercial |
$24,645.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,925.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,164.30
|
| Rate for Payer: Healthscope Commercial |
$25,791.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,492.90
|
| Rate for Payer: Mclaren Medicaid |
$5,052.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,522.52
|
| Rate for Payer: Meridian Medicaid |
$5,304.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,238.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,880.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,358.62
|
| Rate for Payer: Nomi Health Commercial |
$23,498.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,492.90
|
| Rate for Payer: PACE Senior Care Partners |
$6,806.09
|
| Rate for Payer: PACE SWMI |
$7,164.30
|
| Rate for Payer: PHP Commercial |
$24,358.62
|
| Rate for Payer: PHP Medicare Advantage |
$7,164.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,052.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24,931.76
|
| Rate for Payer: Priority Health Medicare |
$7,235.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,945.41
|
| Rate for Payer: Railroad Medicare Medicare |
$7,164.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,218.34
|
| Rate for Payer: UHC Core |
$23,928.76
|
| Rate for Payer: UHC Exchange |
$7,164.30
|
| Rate for Payer: UHC Medicaid |
$5,052.26
|
| Rate for Payer: UHC Medicare Advantage |
$7,164.30
|
| Rate for Payer: UHCCP Medicaid |
$5,052.26
|
| Rate for Payer: VA VA |
$7,164.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,492.90
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$28,657.20
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,945.41 |
| Max. Negotiated Rate |
$25,791.48 |
| Rate for Payer: Aetna Commercial |
$24,358.62
|
| Rate for Payer: BCBS Trust/PPO |
$23,667.98
|
| Rate for Payer: BCN Commercial |
$23,667.98
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cofinity Commercial |
$24,645.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,925.76
|
| Rate for Payer: Healthscope Commercial |
$25,791.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,492.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,358.62
|
| Rate for Payer: Nomi Health Commercial |
$23,498.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,492.90
|
| Rate for Payer: PHP Commercial |
$24,358.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24,931.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,945.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,218.34
|
| Rate for Payer: UHC Core |
$23,928.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,492.90
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$13.96
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$12.56 |
| Rate for Payer: Aetna Commercial |
$11.87
|
| Rate for Payer: Aetna Medicare |
$3.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.36
|
| Rate for Payer: BCBS Complete |
$2.58
|
| Rate for Payer: BCBS MAPPO |
$3.49
|
| Rate for Payer: BCBS Trust/PPO |
$11.48
|
| Rate for Payer: BCN Commercial |
$11.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.49
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$12.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.49
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.47
|
| Rate for Payer: Mclaren Medicaid |
$2.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.66
|
| Rate for Payer: Meridian Medicaid |
$2.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Nomi Health Commercial |
$11.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: PACE Senior Care Partners |
$3.32
|
| Rate for Payer: PACE SWMI |
$3.49
|
| Rate for Payer: PHP Commercial |
$11.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.15
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.28
|
| Rate for Payer: UHC Core |
$11.66
|
| Rate for Payer: UHC Exchange |
$3.49
|
| Rate for Payer: UHC Medicaid |
$2.46
|
| Rate for Payer: UHC Medicare Advantage |
$3.49
|
| Rate for Payer: UHCCP Medicaid |
$2.46
|
| Rate for Payer: VA VA |
$3.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.47
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$13.96
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$12.56 |
| Rate for Payer: Aetna Commercial |
$11.87
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$12.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Nomi Health Commercial |
$11.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: PHP Commercial |
$11.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.28
|
| Rate for Payer: UHC Core |
$11.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.47
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
IP
|
$4,628.79
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,221.64 |
| Max. Negotiated Rate |
$4,165.91 |
| Rate for Payer: Aetna Commercial |
$3,934.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,822.92
|
| Rate for Payer: BCN Commercial |
$3,822.92
|
| Rate for Payer: Cash Price |
$3,703.03
|
| Rate for Payer: Cofinity Commercial |
$3,980.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,703.03
|
| Rate for Payer: Healthscope Commercial |
$4,165.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,471.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,934.47
|
| Rate for Payer: Nomi Health Commercial |
$3,795.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,471.59
|
| Rate for Payer: PHP Commercial |
$3,934.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,027.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,221.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,073.34
|
| Rate for Payer: UHC Core |
$3,865.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,471.59
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
OP
|
$4,628.79
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$816.06 |
| Max. Negotiated Rate |
$4,165.91 |
| Rate for Payer: Aetna Commercial |
$3,934.47
|
| Rate for Payer: Aetna Medicare |
$1,203.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,446.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,446.50
|
| Rate for Payer: BCBS Complete |
$856.79
|
| Rate for Payer: BCBS MAPPO |
$1,157.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,805.33
|
| Rate for Payer: BCN Commercial |
$3,805.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,157.20
|
| Rate for Payer: Cash Price |
$3,703.03
|
| Rate for Payer: Cofinity Commercial |
$3,980.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,703.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,157.20
|
| Rate for Payer: Healthscope Commercial |
$4,165.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,471.59
|
| Rate for Payer: Mclaren Medicaid |
$816.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,215.06
|
| Rate for Payer: Meridian Medicaid |
$856.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,330.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,272.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,934.47
|
| Rate for Payer: Nomi Health Commercial |
$3,795.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,471.59
|
| Rate for Payer: PACE Senior Care Partners |
$1,099.34
|
| Rate for Payer: PACE SWMI |
$1,157.20
|
| Rate for Payer: PHP Commercial |
$3,934.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,157.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$816.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,027.05
|
| Rate for Payer: Priority Health Medicare |
$1,168.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,221.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,157.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,073.34
|
| Rate for Payer: UHC Core |
$3,865.04
|
| Rate for Payer: UHC Exchange |
$1,157.20
|
| Rate for Payer: UHC Medicaid |
$816.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,157.20
|
| Rate for Payer: UHCCP Medicaid |
$816.06
|
| Rate for Payer: VA VA |
$1,157.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,471.59
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
IP
|
$6,656.19
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,632.71 |
| Max. Negotiated Rate |
$5,990.57 |
| Rate for Payer: Aetna Commercial |
$5,657.76
|
| Rate for Payer: BCBS Trust/PPO |
$5,497.35
|
| Rate for Payer: BCN Commercial |
$5,497.35
|
| Rate for Payer: Cash Price |
$5,324.95
|
| Rate for Payer: Cofinity Commercial |
$5,724.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.95
|
| Rate for Payer: Healthscope Commercial |
$5,990.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,992.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.76
|
| Rate for Payer: Nomi Health Commercial |
$5,458.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,992.14
|
| Rate for Payer: PHP Commercial |
$5,657.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,790.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,632.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,857.45
|
| Rate for Payer: UHC Core |
$5,557.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,992.14
|
|
